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A new experience for me

S

SimonMcG

Newbie
Messages
2
Location
Kirkcaldy, Fife, Scotland
I've only recently been diagnosed as being diabetic. My blood sugar level was 24 on Thursday. I received the result on Friday evening and my doctor dropped a prescription off for Metformin and Diastix. I'm back at my docotor's on Monday to find out what happens next. I suppose the first thing to do is get my blood sugar level sorted.
As I say it is all new to me, and just a little bit scary. I suppose the not knowing the details is the really scary bit.
I've been told that if I feel any other weird effects I should contact NHS24 and mention that I am a newly diagnosed diabetic.
I'm sure that given time I'll get there and get in control of this.
 
Hi Simon,welcome to the forum.We know exactly how you feel ,Simon,we've all been there!Especially the part about not being told very much.A blood sugar level(BS) of 24 is very high.the first thing you need to do is get this lower as quickly as possible.Cut out all obvious sugars from your diet.Sugar in tea/coffee,sweets ,etc.You should also cut down the complex carbs to smaller portions than you are eating just now.They are bread,potatoes,rice,pasta and flour based products.Read the product labels of anything you buy.Look at the amount of total carbs in the product ,not just the sugars.The sugars put your BS up quickly but the carbs also convert 100% to glucose so therefore they put up your BS as well.It is very confusing at first so take it a step at a time.Ask us questions ,there's always some one with an answer here.
 
With T2 diabetes, the metformin is to help with reducing your Blood glucose levels,

The diastix the doctor have given you are testing your urine to see if it's got any ketones showing...

You will need to cut out refined sugars, such as sugar in tea/coffee, biscutes, cakes sweet... You will most likely find that you will have to restict starchy complex carbohydrates such a potatoes, bread, rice pasta... How you restrict these, will be partly on how they effect your sugar levels, and how strict you want to be with control... Most of the T2's on the forum do follow a lowcarb diet which they find very helpfull.

To find out how your blood glucose is doing and reacts to carbs, you will need to ask the doctor if he can give you a blood monitoring machine and test strips, which for T2's this will be dependant on the doctor view of giving them to you, but push and this will enable you to monitor and gain control....

There is a lot of information to be taken in, don't worry though as everyone started with the wow whats happening and can I get my head around this? Any question just ask and someone should be able to give a answer and/or point you in the right direction...

But for good low carb recipes check the food forum, you'll find plenty tried and tested ones..
 
hey simon welcome to the club!

this is probably one of the best things to get involved with (ie the forum) as there are many different approaches to how you deal with this, so lots of ideas and plenty of support

at diagnosis i was 21.6 presently about 12 which is still not low enough but halved effectively from when i started

obvious is to cut out sugary things and then see how you go with carbs, some can manage ok with a few, others like me with nearly nothing in terms of carbs

there are some good ideas on food to check out on here, but mainly you have to do what feels right for you i have had some interesting experiments but still here to tell the tale

let us know how you get on and always ask if not sure there is bound to be someone who can help

all the best Jacqui
 
Hi simon
You'll get to grips with this and we'll always be ready to help you, which sounds different from your doctor.
firstly as already correcly stated, Metformin is to help lower your blood glucose. It cannot reduce it from 24 to a normal 5. The only way you can do this at present is to change your way of eating. Cut sugars totally and reduce starches as low as you can. Get used to reading nutrient panels and perhaps get a little book like the Collins Carb guide or the Calorie guide.
Metformin has a tendency to make you nauseous. It's better to take it wih food. Initially 1 x 500mg in the morning. Increasing to 1 at evening tooand then a third at mid-day. It's a very safe medicine.
You need and have a RIGHT to a Blood glucose Meter.Diastix are for testing for Glucose in your urine. Since Glucose doesn't appear in urine until your blood glucose is already high, it's not a lot of use having diastix. Also it can only tell you if your blood glucose was high enough for the glucose to "spill over" since you last emptied your bladder.
Ketostix are for ketones, which also won't help you, because if you are losing weight, you will have them and if you are not, you are in trouble.
If you feel very ill, don't bother ringing NHS direct, get yourself to A&E immediately.
If you make it through this conspicuous lack of care, with your health intact, and still have high blood glucose. they will suggest some stronger medicines, which may have side effects. Going to low carb is safer. Believe it or not, the Atkins diet can be your best friend here.
Get back to us and let us know how you are doing.
 
So far I'd say my doctor and the practice in general have been pretty good. I had my appointment on Thrsday where the urine sample showed pretty high and a blood sample was taken. Friday evening when they got the blood test results back I received a phone call from one of the other GPs in the practice to arrange dropping off the prescription for teststrips and the Metformin at the pharmicist that I always go to. This was picked up by myself yesterday (Saturday) and I have an appointment back at the first GP on Monday at the end of the day (17:20). I know I'm in good hands as the wife of the GP I saw on Thursday, if I remember rightly, heads up the diabetic clinic at my local hospital!

I think, as with everything, it's the initial stages that are the scary bit. I done my shopping today and it's nearly all salad, water, porridge and shredded wheat. No added sugars and as low sugar content as I could find. I've steered clear of fruit because I do like my fruit a bit much and, for the frist time in years, I have gone 3 days so far with no chocolate (Mars in particular). It's been a bit like a smoker stopping immediately and going cold turkey.

I suppose being diagnosed with something at the weekend is never a good time!

It's certainly going to be interesting and will possibly lead me to being healthier than I've ever been. For about 12 years I've been on medication for High Blood Pressure and just 5 weeks ago I was confirmed as having a hiatus hernia. I'd to that the fact that this time last year I wasn't long out of hospital after a really bad spell of depression. If this was last year I'd be handling things very differently. I'm much more positive about it than I would have been.
 
A chronic condition can focus your mind on what is really important and help keep all else in perspective.
What we haven't said so far isthat exercise is beneficial. Walking is enough if you do it every day. If you want to do a little more, there are Health Walk groups all over the country, which do walks of varying difficulty, from an amble along, a mile or so, of canalside on the level, to serious uphill hiking of several miles at a time There are even urban groups that go at lunchtimes for people at work.
I'm retired and walk all journeys up to a mile or so and to the bus stop(1/2 mile away) to use my free bus pass for most others. I rarely use my car.
 
Hi Simon,
First lesson in being a diabetic - its not just added sugar that you need to avoid. Sugar is just one of many forms of carbohydrate, and ALL carbohydrates will increase your blood sugar. Its just that sugar does it immediately, whereas other forms of carbohydrate (like porridge and shredded wheat) take slightly longer. The worst culprits are starchy carbs. Your blood sugar level is very high - about 4 times higher than it should be - so you need to get it reduced. You won't do this overnight but if you simply reduce your intake of starchy carbs as much as possible you should see it coming steadily down over the next week or two. The starchy carbs are found in cereals, bread, pasta, rice and potatoes. That doesn't mean that you shouldn't eat these at all, just eat half of what you would normally eat, and look for low-carb alternatives (e.g. Nimble and Weightwatchers bread is half the carbs per slice than other breads).

Carbs are not just good for you but are essential - but it needs to be the right sort of carbs, like those present in vegetables and some fruits (there are some fruits that are very high in sugar, e.g. bananas and grapes, and are best avoided). All this can be very confusing when you are first diagnosed, but before you know it you will have a built-in mental list of which foods are good for you and which aren't. To get you started can I suggest that you ask Santa for a Collins Little Gem Carb Counter book. These are around £3 from WH Smiths and most other book stores and will tell you what is the carb value of pretty much any food you could want to eat.
 
Sorry Dennis
Carbs ARE NOT essential. You don't need to eat any at all. In fact they are pretty much empty calories.
It has been shown that you can use ketones for energy perfectly well. what little carb may be necessary for your brain ( not confirmed) can be made in your liver by a processs called gluconeogenesis.
I have yet to find anything essential ( ie that you can't get elswhere) in carbohydrate rich foods, succh as grains and white roots. I've been researching this .
 
Actually Hana, I think we are both right to some degree. Certainly the body can use ketones instead of carbs, but ketones are the by-product of burning fat so the body can only do this provided its fat reserves are constantly replenished, otherwise the well simply runs dry - no fat, no ketones. Plus of course continuing ketosis in a body that has depleted fat reserves can result in ketoacidosis.

Gluconeogenesis is the production of glucose by the liver from its reserves of stored glycogen, not the production of carbohydrate. And the primary source of glycogen is from the carbohydrate that we eat. By reducing the amount of carbs that we eat we are also reducing the liver's source of raw material from which to produce glucose.
 
It's more complicated than that, you can generate all the glucose you need from protein - but this is a slow process. I tend to use carbs purely to "trim" my BG when I need to, the control mechanism is busted and I use them as a spot source of glucose while I'm doing stuff to avoid potential highs or lows, which became more common when I tried to drop them too low. Mr(s) Normal can eat a load of carbs and stash the glucose for later, I can only handle the amount I need at the time I eat them, no more and no less (which works out to around 60 - 100g/day but most of them NOT in the morning) this seems to vary a lot between individuals as does their ability to function on ketones.
 

Hi Dennis,

I think you may be thinking of glycogenolysis (the catabolism of glycogen).
Gluconeogenesis is the generation of glucose from non-carbohydrate carbon substrates.

Regards,
timo.
 
Hi Timo,
You are right about the glycogen - it is a product of glycogenolysis.

However Glycolysis is the metabolic pathway that converts glucose (C6H12O6) into pyruvate (C3H5O3). Gluconeogenesis is a metabolic pathway that results in the generation of glucose from what are generally described as non-carbohydrate carbon substrates such as pyruvate, lactate, glycerol, and glucogenic amino acids. Most gluconeogenesis takes place in the liver and, to a smaller extent, in the cortex of kidneys. However, as just mentioned, pyruvate itself is derived from glucose . . . which comes primarily from carbohydrate.
 

Re the ketoacidosis - I thought that ketoacidosis could only occur in the absence of sufficient insulin in the bloodstream ( less than about 20% of normal production I was once told by a consultant). Am I wrong?
Sue
 

Hello Dennis,

I'm sure that someone like Fergus or Hanadr could explain this better than me.
But as I understand it...

In the absence of sufficient dietary carbohydrate, pyruvate can be made from dietary
protein via the transamination of certain amino acids (such as alanine).

Or something like that.

All the best,
timo.
 
diabetesmum said:
Re the ketoacidosis - I thought that ketoacidosis could only occur in the absence of sufficient insulin in the bloodstream ( less than about 20% of normal production I was once told by a consultant). Am I wrong?
Click to expand...
Hi Sue,
Ketoacidosis occurs when the body is producing high levels of ketone bodies via the metabolism of fatty acids (ketosis). The excess ketone bodies can significantly acidify the blood. Where the body is producing insufficient insulin to slow production of ketones then ketoacidosis can occur. The presence of high blood sugar levels (hyperglycemia) caused by lack of insulin can lead to further acidity in the blood. In healthy individuals this normally doesn't occur because the pancreas produces insulin in response to rising ketone/blood sugar levels.

But insufficient insulin is not the only cause of ketoacidosis. If you were to starve the body of carbohydrate then the only way it can get energy is through burning fat (ketosis). If this is overdone then the excess ketone bodies can again acidify the blood. The lack of carbohydrate would mean that there would not be high blood sugar levels, but it is the high ketone levels that cause ketoacidosis - the high blood sugar levels just make it worse.
 
Thanks for the explanation, Dennis. All this time I have thought that only insulin deficient diabetics (usually Type 1's) were at risk of ketoacidosis, but it seems that is not the case. I am interested not only because of my 2 girls (who are Type 1's), but also because of the ketogenic diets (Cambridge, Lighterlife) that are so popular these days.
Sue
 
Hi Sue,
I think its probably safe to say the the vast majority of cases of ketoacidosis are the result of high blood sugar/insufficient insulin. I was really only pointing out that anyone who attempted a zero carb diet over a long enough period could be asking for trouble. I don't know a great deal about the ketogenic diets but they have been around for a number of years so I would have thought they must be safe.
 
Guys guys!
Lysis means splitting, so any process called "*******lysis", involves something being split, as in "analysis" Gluconeogenesis, means making glucose new ( neo) from smaller molecule fragments. I'm not writing out the whole pathway. I had enough of that 40 odd years ago, when I got my degree and I'm sure some of the theories have changed. It's enough that we don't NEED carbs and can chose to eat them if we wish to. Starches in particular are problematic. We can't digesst them if they are not cooked or processed and the foods that contain most of our starches are often toxic, as in green potato or raw beans or raw cereals. Why anyone ever started to eat those things is a mystery.

A zero carb diet has been tried and found to be safe. However, It's difficult to do, Pretty much only fatty mea is eaten. All veggies have some carbs.Bernsein advocates 30carbs per day. Atkins, only 20 for diabetic control. Even that isn't easy.
For a newbie, just leaving out the sugars and cutting back on the starchy stuff is probably enought to get to grips with. And is likely to be a drastic drop in carbs. Then they have to geet used to the idea that fat isn't the enemy and that on this forum is more knowldge than the average GP or DSN has.
 
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